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Childhood Illnesses
and Conditions
: Croup in Children
What causes croup?
Croup is caused by an inflammation(swelling) of the upper airway
(larynx or voice box and the trachea or windpipe). The inflammation
is usually due to a viral infection, and is a common condition
in young children. Croup is also known as stridorous laryngitis.
Viral croup is more common in children less than 5 years of age
and is very rarely seen in adults.
What are the symptoms of croup?
Typically, viral croup begins with a cold, that slowly develops
into a characteristic "seal-like" barking cough and a high pitched,
raspy noise when breathing in, known as "stridor". The stridor
often gets worse with physical activity. Most children with viral
croup have a low-grade fever. The potential problems of croup
depend on how much the upper airway is blocked by the swelling.
The more the airway is blocked, the more the child's breathing
is labored and in general the less active is the child. Additionally,
an important sign of difficulty breathing is that the child may
stop eating or drinking. Croup typically worsens at night, lasts
for 3-4 days and usually subsides on its own. Often the severity
of the croup is measured by the "Croup Score" which takes into
account a child's breathing rate/pattern and color. The higher
the score, the more severe the infection. The croup scores help
the medical personnel classify the croup as either mild, moderate
or severe.
How is croup treated?
The cough and stridor of croup may be quite scary, but fortunately
most cases are mild, and need no other treatment or medical intervention.
The type of treatment(if any) depends of course on the severity
of the symptoms.
Mild croup:
The treatment approach is simple: exposure to cold humid air.
This is achieved either by opening up a window or taking the child
outside. Another way is to let the shower run, preferably with
cold water, and to let the child sit in the bathroom to breath
in the cold humid mist. Usually, children start to breathe more
easily within 15 minutes of exposure to cold humid air. During
the rest of the croup illness a cold water humidifier or vaporizer
in the room during the night is also recommended.
Moderate to severe croup:
In the most serious cases, a child may have so much difficulty
breathing that he/she is not getting enough oxygen into the blood.
In this situation, the child will need to go to the hospital.
Signs that a child with croup needs immediate medical attention
include:
Stridor that is getting louder with each breath
Inability to speak because of lack of breath
Labored and or rapid breathing
Pale or bluish mouth or fingernails
Stridor at rest
Drooling
Inability to eat or drink enough
At the hospital, the child will be evaluated and given oxygen
if necessary.In order to ensure that the child does not become
dehydrated, an intravenous may be started. Although there are
no specific medications for croup, steroid injections and adrenaline-like
inhaled preparations are used to help children with moderate to
severe croup. These medications act to decrease the swelling of
the upper airway. Some recent studies have suggested that administration
of inhaled steroids by mask may also help, but this is still controversial.
Can croup recur?
Yes, some children seem to have repeated episodes of croup called
"spasmodic croup". In this case, the child gets a cold, rarely
with fever, and then the typical "croup" begins. In some cases
spasmodic croup may begin suddenly without any preceding cold
symptoms. Unlike viral croup, spasmodic croup usually recurs,
can occur in older children and is thought to be related to allergies.
Of course in rare cases if a child suffers from repeated episodes
of severe croup requiring hospitalization, specific tests are
performed by an Ear, Nose and Throat(ENT) doctor to ensure there
are no vocal cord or other laryngeal problems/anomalies. Fortunately
in the vast majority of children with viral and/or spasmodic croup
there is no underlying airway abnormality.
Other Childhood Illnesses
and Conditions |
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The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
© Autograph Communications Inc.,
All rights reserved
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